儿童体位性心动过速综合征临床分析

Clinical analysis of postural orthostatic tachycardia syndrome

目的:探讨儿童体位性心动过速综合征(POTS)的临床特征。方法:以符合POTS诊断标准的40例患儿为研究对象,分析年龄分布、家族遗传特征及血液动力学指标,同时观察其各种临床表现的发生频率及辅助检查结果。结果:诊断为POTS的患儿40例,其中男性15例,女性25例,男女比例为1:1.7,年龄10～16岁,平均为14±1.5岁,10例具有家族遗传性,占25%。最常见临床表现为直立后出现头晕、头痛、胸闷、心悸、面色改变、视物模糊、倦怠、晨起不适,严重时甚至出现眩晕、晕厥等直立不耐受或直立调节障碍症状。在直立试验(先安静平卧10min,然后直立10min)或直立倾斜(HUT)试验过程中,POTS患儿最常见的异常表现为在直立或倾斜后10 min内,心率增加≥35次/min,或患儿心率测最大值≥120次/min,但血压下降<20/10 mmHg为诊断标准。出现异常表现的时间平均为7±2 min,15例直立6 min出现异常症状,10例在直立后即可出现异常症状,15例作HUT约10 min内出现异常症状。结论:POTS常见于学龄期女童,有一定的遗传性,常见的症状为头晕、胸闷、心慌等,HUT为诊断POTS敏感且重要的方法。

Objective： The aim of this article is to analyze the clinical characteristics of POTS in children. Methods： All 40 pediatric patients of POTS who met the diagnostic criteria were investigated age and gender distribution, and familial hereditary features were observed, and hemodynamic indexes were also recorded. The frequency of symptoms, and results of auxiliary examination were also analysed. Results ：40 patients were diagnosed as POTS. 15patients were males and 25 patients were females among them. The ratio of male to female was 1 ： 1.7 ; All the 40 cases were from 10 to 16 years old. There are familial hereditary features in 10 patients ,occupying 25% of all the cases. The most common orthostatic symptoms were lightheadedness or dizziness, syncope, chest discomfort,pallor and blurred vision associated with nausea and/or vomiting. The average time of the occurrence of abnormal responses was about （ 7 ± 2 ） min. There was abnormal symptom in 15 patients within 6 minutes, 10 patients in 10 immediately after standing up, and 15 patients about within 10 minutes after HUT respectively. Conclusion： POTS is commonly seen in school-aged girls. And it has the heredity tendency. The common symptoms include dizziness, chest distress and palpitation. HUT is a sensitive and important method in its diagnosis.